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Basics of the US Health Care System Basics of the U.S. Health Care System Third Edition Nancy J. Niles, MPH, MS, MBA, PhD Associate Professor, Rollins College, Winter Park, Florida 9781284103007_FMxx_Pass01.indd 1 10/17/16 6:43 PM World Headquarters Jones & Bartlett Learning 5 Wall Street Burlington, MA 01803 978-443-5000 [email protected] www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com. Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to [email protected]. Copyright © 2017 by Jones & Bartlett Learning, LLC, an Ascend Learning Company All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett Learning, LLC. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not constitute or imply its endorsement or recommendation by Jones & Bartlett Learning, LLC and such reference shall not be used for advertising or product endorsement purposes. All trademarks displayed are the trademarks of the parties noted herein. Basics of the U.S. Health Care System, Third Edition is an independent publication and has not been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product. There may be images in this book that feature models; these models do not necessarily endorse, represent, or participate in the activities represented in the images. Any screenshots in this product are for educational and instructive purposes only. Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for instructional purposes only. This publication is designed to provide accurate and authoritative information in regard to the Subject Matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the service of a competent professional person should be sought. Production Credits VP, Executive Publisher: David D. Cella Composition and Project Management: Integra Software Services Publisher: Michael Brown Pvt. Ltd. Associate Editor: Lindsey Mawhiney Cover Design: Kristin Parker Associate Editor: Danielle Bessette Rights & Media Specialist: Merideth Tumasz Production Manager: Carolyn Rogers Pershouse Cover Image: Senior Vendor Manager: Tracey McCrea Printing and Binding: Edwards Brothers Malloy Manufacturing and Inventory Control Supervisor: Amy Bacus Cover Printing: Edwards Brothers Malloy Library of Congress Cataloging-in-Publication Data Names: Niles, Nancy J., author. Title: Basics of the U.S. health care system / Nancy Niles. Description: Third edition. | Burlington, MA : Jones & Bartlett Learning, [2018] | Includes bibliographical references and index. Identifiers: LCCN 2016045762 | ISBN 9781284103007 (pbk.) Subjects: | MESH: Delivery of Health Care | Insurance, Health | National Health Programs | United States Classification: LCC RA445 | NLM W 84 AA1 | DDC 362.1--dc23 LC record available at https://lccn.loc.gov/2016045762 6048 Printed in the United States of America 20 19 18 17 16 10 9 8 7 6 5 4 3 2 1 9781284103007_FMxx_Pass01.indd 2 10/17/16 6:43 PM Hospital: © Stephen Mahar/ShutterStock, Inc.; Monitor: © Getty Images; Medical Form: Shutterstock / Pixsooz Brief Contents About the Author viii Acknowledgments ix Preface x Chapter 1 History of the U.S. Healthcare System ..............................1 Chapter 2 Impact of the Affordable Care Act on Healthcare Services ............29 Chapter 3 Current Operations of the Healthcare System .......................57 Chapter 4 Government’s Role in U.S. Health Care .............................91 Chapter 5 Public Health’s Role in Health Care ...............................114 Chapter 6 Inpatient and Outpatient Services ...............................146 Chapter 7 U. S. Healthcare Workforce .....................................173 Chapter 8 Healthcare Financing. .200 Chapter 9 Managed Care Impact on Healthcare Delivery .....................229 Chapter 10 Information Technology Impact on Health Care ....................251 Chapter 11 Healthcare Law ...............................................277 Chapter 12 Healthcare Ethics .............................................308 Chapter 13 Mental Health Issues ..........................................338 Chapter 14 Analysis of the U.S. Healthcare System ...........................367 Glossary 000 Index 000 iii 9781284103007_FMxx_Pass01.indd 3 10/17/16 6:43 PM Hospital: © Stephen Mahar/ShutterStock, Inc.; Monitor: © Getty Images; Medical Form: Shutterstock / Pixsooz Contents About the Author . viii Stakeholders’ Environment . 62 Acknowledgments . ix Healthcare Statistics . .62 Preface . .x Conclusion . .77 Vocabulary . .78 Chapter 1 History of the U .S . Healthcare References . .78 System . 1 Notes .. 79 Introduction . 2 Student Activities . 80 Consumer Perspective on Health Care . 3 Chapter 4 Government’s Role in U .S . Health Milestones of the Hospital System . 8 Care . 91 Milestones of Public Health . 9 Introduction . 92 Milestones of the Health Insurance System . .10 History of the Role of Government in Current System Operations . .12 Health Care . 92 Assessing Your Healthcare System Using the Iron U .S . Government Agencies. 92 Triangle . .13 Conclusion . .99 Conclusion . .13 Vocabulary . .99 Vocabulary . .14 References . 100 References . .14 Notes .. 101 Notes .. 16 Student Activities . 102 Student Activities . 17 Chapter 5 Public Health’s Role in Chapter 2 Impact of the Affordable Care Act Health Care . 114 on Healthcare Services . 29 Introduction . 115 Introduction . 30 What Is Health? . 115 Legal Issues with the Affordable Care Act . .30 Origins of Public Health . 117 Major Provisions of the Affordable Care Act . .31 What Is Public Health? . 117 Conclusion . .40 The Epidemiology Triangle. 118 Vocabulary . .41 Epidemiologic Surveillance . 118 References . .42 Environmental Health . 119 Notes .. 44 Emergency Preparedness . 119 Student Activities . 45 State and Local Response to Disasters. 121 Chapter 3 Current Operations of the Bioterrorism . 122 Healthcare System . 57 Public Health Functions and Administration. 123 Introduction . 58 Healthy People Reports . 124 Overview of the Current System Update . .58 Public Health Infrastructure . 124 Major Stakeholders in the Healthcare Industry . .58 Public Health Education and Health Promotion . 128 iv 9781284103007_FMxx_Pass01.indd 4 10/17/16 6:44 PM Contents v Collaboration of Public Health and Notes .. 187 Private Medicine . 129 Student Activities . 188 Conclusion . 129 Vocabulary . 130 Chapter 8 Healthcare Financing . 200 References . 131 Introduction . 200 Notes .. 133 Healthcare Spending by Service Type . 201 Student Activities . 134 Healthcare Spending by Sources of Funds . 202 Health Insurance as a Payer for Healthcare Chapter 6 Inpatient and Outpatient Services . 202 Services . 146 Types of Health Insurance . 203 Introduction . 147 Cost Sharing of Health Services . 203 History of Hospitals . 147 Types of Health Insurance Plans . 204 Hospital Types by Ownership . 148 Public Financing of Healthcare Services . 206 Hospital Types by Specialty . 148 Reimbursement Methods of Private Health Other Hospital Classifications . 148 Insurance Plans . 209 Hospital Governance . 149 Governmental Reimbursement Methods for Healthcare Services . 210 Hospital Licensure, Certification, and Accreditation . 150 Healthcare Financial Management . 213 Patient Rights. 150 Funds Disbursement. 213 Current Status of Hospitals . 150 Conclusion . 213 Outpatient Services .. 152 Vocabulary . 214 Other Health Services. 154 References . 214 Conclusion . 157 Notes .. 216 Vocabulary . 157 Student Activities . 217 References . 158 Chapter 9 Managed Care Impact on Notes .. 160 Healthcare Delivery . 229 Student Activities . 161 Introduction . 230 Chapter 7 U .S . Healthcare Workforce . 173 History of Managed Care . 230 Introduction . 173 The Managed Care Organization Payment Plan . 232 Primary, Secondary, and Tertiary Care . 174 Cost-Control Measures of Managed Care Physician Education . 174 Organizations . 232 Generalists and Specialists . 175 Medicare and Medicaid Managed Care . 233 Differences Between Primary and Assessment of Managed Care Models. 234 Specialty Care . 175 Managed Care Accreditation .. 235 Types of Healthcare Providers . 176 Issues with Managed Care Operations . 235 Other Independent Healthcare Professionals . 178 Challenges to Managed Care . 235 Allied Health Professionals . 180 Conclusion . 236 Non-CAAHEP Allied Health Professionals . 183 Vocabulary . 236 Conclusion . 184 References . 237 Vocabulary . 185 Notes .. 238 References . 185 Student Activities . 239 9781284103007_FMxx_Pass01.indd
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